Tuberculosis (TB) is one of the leading causes of death for people with HIV. HIV damages your immune system and makes you more vulnerable to contracting serious bacterial infections such as TB.
People who live in areas where TB is more common are at higher risk, but all people with HIV are considered to be at a high risk of contracting TB. Regular testing is encouraged. TB can be cured in people with HIV when it’s found and treated early and appropriately. Treatment can vary depending on your infection and on the specific medications you’re taking for HIV.
A latent TB infection is an infection that occurs when the amount of TB bacteria in your body is too small to cause any symptoms. Latent TB can last years or even for your entire lifetime. If you’re healthy, your immune system keeps a latent TB infection under control and prevents it from ever causing symptoms.
HIV weakens your immune system. This can allow a latent TB infection to turn into an active infection. An active TB infection can be fatal. Additionally, TB bacteria can speed up the progression of an HIV infection.
Globally, TB is one of the leading causes of death for people with HIV. If you have both HIV and TB, you have double the risk of death than if you have TB alone. Those with HIV are especially at risk in countries with high rates of TB, such as India and South Africa. It also disproportionately affects those in overcrowded or informal housing and those in prison.
Multi-drug-resistant and extremely drug-resistant TB also have a higher impact on individuals in certain places such as Ukraine, Russia, and former United Socialist Soviet Republic countries and South Africa and South-East Asia who have developed an HIV infection.
Is tuberculosis a symptom of HIV?
TB isn’t a symptom of HIV. But HIV can activate a latent TB infection. People with healthy immune systems can have latent TB infections that never progress to active TB and that never cause any health concerns.
Because HIV weakens your immune system, it can cause a latent TB infection to become a life threatening active TB infection. So, although TB isn’t a symptom of HIV, active TB is frequently a result of HIV.
The U.S. Centers for Disease Control and Prevention (CDC)
- live or work in correctional facilities, long-term care facilities, homeless shelters, or other high-risk settings
- have spent time with someone with an active TB infection
- are a healthcare worker who provides care for people who are high risk
- are teens, children, and infants who’ve been exposed to adults who are at increased risk or who have a TB infection
- live in a country where TB is common
- have symptoms of TB
- have HIV
Generally, testing is done annually for people in these situations. TB testing is done by either taking a sputum, or a combination of saliva and mucus from your lower airways, smear and culture or molecular tests such as GeneXpert. Both options are safe for people with HIV.
In recent years, molecular testing has also become an option for people with HIV. These tests can diagnose TB faster and more accurately than traditional TB testing. They can also find drug-resistant forms of TB. Positive molecular or traditional tests might be followed by lung x-rays and urine analysis.
There are many treatment options available for people with HIV and TB. The exact treatment will depend on whether your infection is latent or active and on other factors. Latent TB
- A daily dose of rifampin for 4 months. Rifampin can’t be used with some antiretroviral medications and is known to affect birth control medication.
- A weekly dose of rifapentine for 12 weeks. This is the newest Food and Drug Administration (FDA)-approved treatment.
- A daily dose of isoniazid for 9 months. Isoniazid is often used for people with HIV who can’t take rifampin or rifapentine.
Active TB infections
- A daily high dose of rifapentine for 4 months along with moxifloxacin (MOX), isoniazid (INH), and pyrazinamide (PZA). The medication is given at higher doses for the first weeks and lower doses for the remaining 9 weeks.
- Moderate doses of rifampin, MOX, INH, and PZA for 6 to 9 months. The minimum for this regime is 6 months.
- Up to 2 years of treatments for people with drug-resistant TB. Drug-resistant TB often requires treatment with multiple antibiotics. When drug-resistant TB is suspected or identified, referral to a TB specialist, is critical.
There have been multiple studies looking into the connections between HIV and TB.
Findings have indicated a need for education, prevention, and further research and have also found an increased risk of TB among:
- people with HIV who are more than 40 years old
- people with HIV who live in South-East Asia
- people who were assigned male at birth and have HIV
- people who’ve recently received a diagnosis of HIV
- people in prison or other overcrowded housing
Yes. TB is curable in people with HIV.
TB without treatment can cause rapid health decline and death in people with HIV, but with treatment, TB infections are curable. People with HIV
Living with HIV
HIV can be an overwhelming diagnosis to manage and live with. Connecting with resources and support can be a huge help. Some places to turn include:
- POZ Community Forums. You’ll find a discussion board that allows you to interact with people who’ve received a positive (or “poz”) diagnosis of HIV for information, support, and more at the POZ Community Forums.
- The Well Project. Women and girls with HIV will find support and community with forums hosted at The Well Project.
- Positive Peers. Positive Peers is a smartphone app for people between 13 and 34 years old with HIV to use to connect with each other and get support.
- Thrive SS. Thrive SS offers support for Black men who are gay or bisexual and who’ve received a diagnosis of HIV. Local chapters host community events and mental health support groups.
- The Ryan White HIV/AIDS Program. The Ryan White HIV/AIDs program can help you pay for your medical care if you meet certain income requirements.
- Housing Opportunities for Persons With AIDS (HOPWA). HOPWA is a federal program that helps people with HIV and AIDS and their families secure housing.
People with HIV are at higher risk of contracting a TB infection. HIV weakens your immune system and can cause a latent HIV infection to turn into a potentially fatal active infection.
TB is curable in people with HIV, but finding and treating it is important. It’s recommended that people with HIV are tested for TB at least once a year.
Treatment for TB for people with HIV will depend on whether your infection is latent or active and how you respond to medications. Treatment can be completed in as little as 4 months or it could take years if you have a drug-resistant TB infection.